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These within-therapist differences hold promise for personalizing care by prospectively matching patients to therapists\u2019 historical effectiveness strengths. In a double-masked randomized controlled trial (RCT; NCT02990000), such matching outperformed pragmatically determined usual case assignment\u2014which leaves personalized, measurement-based matching to chance\u2014in naturalistic outpatient psychotherapy (Constantino et al., JAMA Psychiatry 78:960\u2013969, 2021). Demonstrating that personalization can be even more precise, some research has demonstrated that the strength of this positive match effect was moderated by certain patient characteristics. Notably, though, it could also be that matching is especially important for some <jats:italic>therapists<\/jats:italic> to achieve more effective outcomes. Examining this novel question, the present study drew on the Constantino et al. (JAMA Psychiatry 78:960\u2013969, 2021) trial data to explore three therapist-level moderators of matching: (a) effectiveness \u201cspread\u201d (i.e., greater performance variability across patients\u2019 presenting problem domains), (b) overestimation of their measurement-based and problem-specific effectiveness, and (c) the frequency with which they use patient-reported routine outcomes monitoring in their practice. Patients were 206 adults, randomized to the match or control condition, treated by 40 therapists who were crossed over conditions. The therapist variables were assessed at the trial\u2019s baseline and patients\u2019 symptomatic\/functional impairment and global distress were assessed regularly up to 16\u00a0weeks of treatment. Hierarchical linear models revealed that only therapist effectiveness spread significantly moderated the match effect for the global distress outcome; for therapists with more spread, the match effect was more pronounced, whereas the match effect was minimal for therapists with less effectiveness spread. Notably, two therapist-level covariates unexpectedly emerged as significant moderators for the symptomatic\/functional impairment outcome; for clinicians who consistently treated patients with higher versus lower average severity levels and who relatedly treated a higher proportion of patients with <jats:italic>primary<\/jats:italic> presenting problems of substance misuse or violence, the beneficial match effect was even stronger. Thus, measurement-based matching may be especially potent for therapists with more variable effectiveness across problem domains, and who consistently treat patients with more severe presenting concerns or with particular primary problems, which provides further precision in conceptualizing personalized care.<\/jats:p>","DOI":"10.1007\/s10488-024-01360-8","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T19:01:47Z","timestamp":1712084507000},"page":"738-752","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Therapist-Level Moderators of Patient-Therapist Match Effectiveness in Community Psychotherapy"],"prefix":"10.1007","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5950-0486","authenticated-orcid":false,"given":"Alice E.","family":"Coyne","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3126-2575","authenticated-orcid":false,"given":"Michael J.","family":"Constantino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6214-0787","authenticated-orcid":false,"given":"James F.","family":"Boswell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-7059","authenticated-orcid":false,"given":"Averi N.","family":"Gaines","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Kraus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"issue":"1","key":"1360_CR1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1037\/ccp0000644","volume":"90","author":"JF Boswell","year":"2022","unstructured":"Boswell, J. F., Constantino, M. J., Coyne, A. E., & Kraus, D. R. (2022). For whom does a match matter most? Patient-level moderators of evidence-based patient-therapist matching. Journal of Consulting and Clinical Psychology, 90(1), 61\u201374. https:\/\/doi.org\/10.1037\/ccp0000644","journal-title":"Journal of Consulting and Clinical Psychology"},{"issue":"4","key":"1360_CR2","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1007\/s10488-015-0649-6","volume":"43","author":"JF Boswell","year":"2016","unstructured":"Boswell, J. F., Constantino, M. J., Kraus, D. R., Bugatti, M., & Oswald, J. M. (2016). The expanding relevance of routinely collected outcome data for mental health care decision making. 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E., Muir, H. J., Gaines, A. N., & Kraus, D. R. (2023). Therapist perceptions of their own measurement-based, problem-specific effectiveness. Journal of Consulting and Clinical Psychology, 91(8), 474\u2013484. https:\/\/doi.org\/10.1037\/ccp0000813","journal-title":"Journal of Consulting and Clinical Psychology"},{"issue":"9","key":"1360_CR5","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1001\/jamapsychiatry.2021.1221","volume":"78","author":"MJ Constantino","year":"2021","unstructured":"Constantino, M. J., Boswell, J. F., Coyne, A. E., Swales, T. P., & Kraus, D. R. (2021). Enhancing mental health care by matching patients to providers\u2019 empirically derived strengths: A randomized clinical trial. JAMA Psychiatry, 78(9), 960\u2013969. https:\/\/doi.org\/10.1001\/jamapsychiatry.2021.1221","journal-title":"JAMA Psychiatry"},{"key":"1360_CR6","doi-asserted-by":"publisher","unstructured":"Coyne, A. E. (2024). 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No other known conflicts of interest were reported.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was not pre-registered. We will maintain our deidentified data set indefinitely given possible future requests (e.g., to extract data for meta-analyses). Upon request, on a case-by-case basis, we can share individual participant data (again, following full deidentification) that underlie results in a publication. All such requests, including a detailed plan for how the data will be used, should be directed to Dr. Michael Constantino at constanm@umass.edu. Dr. Constantino reserves the right to deny individual share requests if the usage details are questionable or unclear.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publications"}}]}}